Methods

The Fishbone diagram technique was employed to identify root causes, leading to the development of targeted interventions which were all low cost. Root causes identified included; lack of screening skills among staffs (Where some staffs were only relying on RDT, which detects p. falciparum only), insufficient test kits and lab commodities (e.g. Running out of RDT kits, Giemsa solutions, glass slides etc.), poor community engagement and lack of IEC and poor documentation.

The interventions implemented were: targeted orientations and Technical Support to staffs who were identified lacking skills in terms of malaria screening and management, lobbying of more test kits from District Health Office, ZAMMSA and other partners, proper usage of lab commodities by lab staffs were employed, conducted Orientations on proper documentation to departmental staffs, and emphasis to be giving Information Education on every malaria patient was intensified at all service delivery points and stuck malaria guidelines on the walls in specific rooms. Key stakeholders (village headmen, political leaders, schools and churches) were also engaged in distributing the information about early health seeking behaviours, proper usage of mosquito nets and refraining from the myths about the mosquito nets (e.g. means of controlling world population and suffocating once you sleep under it)